王爱宏

[摘要] 目的 探讨阴道镜下宫颈活检联合宫颈锥切在宫颈病变诊疗中的临床价值。方法 方便选取2014月12月—2015年12月该院妇科门诊就诊的宫颈病变患者41 例，均先后接受阴道镜定位下宫颈组织活检及诊断性宫颈锥切，并对宫颈活检组织与宫颈锥切组织给予病理学检查，对检查结果进行分析。结果 宫颈活检组织病理结果： 慢性宫颈炎6 例； CINⅠ级10 例； CINⅡ级16 例； CINⅢ级9 例。宫颈锥切组织病理结果： 慢性宫颈炎12 例； CINⅠ级10 例； CINⅡ级10 例； CINⅢ级7 例，局灶为浸润性鳞癌1 例； 腺癌1 例。 结论 阴道镜下宫颈活检联合锥切在宫颈病变的早期诊断和早期治疗中有着重要的价值。

[关键词] 宫颈癌前病变；宫颈活检；宫颈锥切

[中图分类号] R737 [文献标识码] A [文章编号] 1674-0742（2017）01（c）-0187-04

Clinical Value of Cervical Biopsy and Conization in the Diagnosis and Treatment of Cervix Lesions Under Colposcopy

WANG Ai-hong

Department of gynaecology， the Peoples Hospital of Feicheng City， Feicheng， Shandong Province， 271600 China

[Abstract] Objective To study the clinical value of cervical biopsy and conization in the diagnosis and treatment of cervix lesions under colposcopy. Methods Convenient selection 41 cases of patients with cervix lesions admitted and treated in the outpatient department in our hospital from December 2014 to December 2015 were retrospectively analyzed， and given the colposcopy-oriented cervical biopsy and diagnosis cervical conization， and the cervical biopsy tissue and cervical conization tissues were given the pathological examination， and the examination results were analyzed. Results The cervical biopsy tissue pathology results： chronic cervicitis was in 6 cases， CINⅠ was in 10 cases， CINⅡ level was in 16 cases and CINⅢ was in 9 cases， and the cervical conization tissue pathology results： chronic cervicitis was in 12 cases， CINⅠ level was in 10 cases， CINⅡ level was in 10 cases and CINⅢ level was in 7 cases， and the invasive squamous cell carcinoma was in 1 case and adenocarcinoma was in 1 case. Conclusion The cervical biopsy combined with conization is of important value in the early diagnosis and treatment of cervix lesions.

[Key words] Precancerous lesions of uterine cervix； Cervical biopsy； Cervical conization

对于宫颈癌前病变，通常采用“三阶梯法”（ 细胞学-阴道镜-组织学） 的步骤进行诊治，并针对活检病理诊断高级别的部分患者给予相应治疗。早期病变的治疗大多选择在门诊行LEEP 术，而对于晚期病变，如浸润癌及腺癌的治疗，则视具体情况而定。但是，阴道镜检由于只选取部分组织，漏诊现象时有发生。临床上我们经常遇到宫颈LEEP术后的病理，较活检病理升级的情况，尤其是阴道镜检查不满意，病变部位不在阴道镜暴露范围以内导致取材不理想时，所以，如果直接以阴道镜定位活检病理结果为依据，采取相应治疗方案显然已经不是最佳选择。而联合使用宫颈锥切（大多选择在门诊行LEEP 术）可弥补这一不足，其获取所有位点的组织，能大大提高组织学诊断的准确性。……